Hermon Family Dental, PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4141 Issued in ME

Legal business name

HERMON FAMILY DENTAL, PA

Practice address

2402 Route 2
Suite E
Hermon, ME 04401-0665

Phone

(207) 848-2555

Fax

(207) 848-9012

NPI assigned

Sep 13, 2013

Last updated

Sep 13, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Benjamin G Phillips, DDS

Title

Owner

Phone

(207) 848-2555

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1003241654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 ROUTE 2",
            "address_2": "SUITE E",
            "city": "HERMON",
            "state": "ME",
            "postal_code": "044010665",
            "telephone_number": "207-848-2555",
            "fax_number": "207-848-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 ROUTE 2",
            "address_2": "SUITE E",
            "city": "HERMON",
            "state": "ME",
            "postal_code": "044010665",
            "telephone_number": "207-848-2555",
            "fax_number": "207-848-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERMON FAMILY DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-848-2555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ME",
            "license": "4141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Mae Goodwin, OTA
• Samantha Jamie Gray, DDS
• Sheridan Louise Hanlon, COTA/L
• Riley Dana-Marie Hanson
• Lacey Henderson
• Hermon Volunteer Rescue and First Aid Squad, Inc (Hermon Vol Rescue Squad)
• Rebecca Rose Hollins, PHARMD
• Shelley Renee Illingworth, RPH
• Lauren Jellison, NP
• Nancy A Jewett, LCPC-C

• Dental Clinic/Center in Hermon, ME
• Providers in Hermon, ME by specialty
• Dental Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.